MEDICARE: NATHALIA EUN HYE KIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	28686	CA

General Provider Information

NPI Number	:	1578413183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHALIA EUN HYE KIM

Provider Business Mailing Address
First Line	:	273 E BEVERLY BLVD, MONTEBELLO, CA 90640
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	273 E BEVERLY BLVD, MONTEBELLO, CA 90640
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640
Country	:	US
Telephone Number	:	323-724-5100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/03/2026

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